NPIMap

Organization Active NPI

Chiropractic Wellness PS Inc

  • Chiropractor
  • Spokane Valley, WA
National Provider Identifier
1053671511
Registry record updated Sep 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH3411 Issued in WA
Legal business name
CHIROPRACTIC WELLNESS PS INC
Practice address
618 N Sullivan Rd Ste 21
Address 2
Spokane Valley, WA 99037-8528
Phone
(509) 926-7789
Fax
(509) 926-7576
NPI assigned
May 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. James William Tucker, DCNPI 1548348014
Title
Owner/President
Phone
(509) 926-7789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH3411 WA Primary

Addresses

Primary practice location

618 N Sullivan Rd Ste 21
Address 2
Spokane Valley, WA 99037-8528

Mailing address

618 N Sullivan Rd Ste 21
Address 2
Spokane Valley, WA 99037-8528
Phone (509) 926-7789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120807000932 WA Part B Supplier - Clinic/Group Practice 5395991327 Receives reassigned benefits from 1 practitioner
Practice locations: Spokane Valley, WA

National Provider Directory

National Provider Directory

Locations

618 N Sullivan Rd
Ste 21
Spokane Valley, WA 99037
Phone (509) 926-7789

618 N Sullivan Rd
Ste 21
Spokane Valley, WA 99037
Phone (509) 714-0849

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504742400000",
    "number": "1053671511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 N SULLIVAN RD STE 21",
            "address_2": "ADDRESS 2",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378528",
            "telephone_number": "509-926-7789",
            "fax_number": "509-926-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N SULLIVAN RD STE 21",
            "address_2": "ADDRESS 2",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378528",
            "telephone_number": "509-926-7789",
            "fax_number": "509-926-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC WELLNESS PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2017-09-07",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "509-926-7789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH3411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.